Collaboration and Teamwork Allowed Reduction in Unintended Extubations in Neonatal ICU

MedicalResearch.com Interview with:

John P. Galiote, M.D.Neonatologist at Children’s National-Virginia Hospital Center NICU

Dr. Galiote

John P. Galiote, M.D.
Neonatologist at Children’s National-Virginia Hospital Center NICU

Michelande Ridoré, MS, NICUQuality improvement lead at Children’s National 

Ms. Ridoré

Michelande Ridoré, MS, NICU
Quality improvement lead at Children’s National

Lamia Soghier, M.D., MEd, Children’s National NICU medical director

Dr. Soghier

 

Lamia Soghier, M.D., MEd, Children’s National NICU Medical Director

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our study emphasizes the importance of team work and real-time communication in a quality-improvement project within the neonatal intensive care unit (NICU) setting.

Through bedside huddles, weekly reviews of apparent cause analysis reports reducing the frequency of X-rays and the creation of an Airway Safety Protection Team, we were able to focus not only on  reducing unintended extubations, but also on the quality-improvement project’s effect on our staff. Adhering to simple quality principles enabled us to ensure that all members of our staff were heard and had a positive effect on the progress of our project. This allowed us to implement and sustain a series of simple changes that standardized steps associated with securing and maintaining an endotracheal tube (ET). Unintended extubations are the fourth-most common adverse event in the nation’s NICUs. Continual monitoring via this quality-improvement project allowed us to intervene when our rates increased and further pushed our unintended extubation rate downward. Continue reading

NICU Babies’ Parents at Risk For Depression

MedicalResearch.com Interview with:

Karen Fratantoni, M.D., M.P.H. Pediatrician and lead study author Children’s National Health System

Dr. Fratantoni

Karen Fratantoni, M.D., M.P.H.
Pediatrician and lead study author
Children’s National Health System

MedicalResearch.com: What is the background for this study?

Response: We looked at the prevalence of depressive symptoms at NICU discharge and at six months after discharge among 125 parents randomized to the control group of a larger PCORI-funded trial of peer-to-peer support after NICU discharge. Determining factors associated with parental depressive symptoms at NICU discharge may help to identify at-risk parents who could benefit from mental health support.

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Simulation Exercises Reduce Anxiety of Taking Baby Home From NICU

MedicalResearch.com Interview with:

Deborah A. Raines PhD, EdS, RN, ANEF School of Nursing University at Buffalo

Dr. Raines

Deborah A. Raines PhD, EdS, RN, ANEF
School of Nursing
University at Buffalo

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This research grew from my experience as a neonatal nurse. I have worked with many families preparing to take their baby home and have seen the anxiety they experience wondering if they will be able to take care of their baby’s medical needs at home.

Parents are usually most anxious about emergency situations that may occur. Majority of these parents are able to state what they should do, but have never experienced the actual situation with their baby. This study was designed to see if a simulation experience would fill this gap in parents’ preparation for the discharge of their baby from the NICU. This study had parents participated in a customized simulation to have them experience the care needed by their baby at home following discharge from the NICU.

The findings revealed that parents reported a nearly 30 percent increase in confidence in their abilities to care for their baby after participating in the simulation.

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Autism Disorders after NICU Stays

Dr. Michael Shevell Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health CentreMedicalResearch.com Interview
Dr. Michael Shevell
Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health Centre

MedicalResearch.com: What are the main findings of the study?

Dr. Shevell: At risk term infants who have spent some time in a Level III NICU after birth are at substantially increased later risk for an autistic spectrum disorder. Frequently this disorder occurs in conjunction with substantial co-morbidity.
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Neonatal Intensive Care Unit and Vancomycin-resistant Enterococcus outbreak

MedicalResearch.com Interview with:
Elias Iosifidis, MD, PhD
Pediatric Infectious Disease Fellow
Aristotle University of Thessaloniki
Hippokration Hospital
Thessaloniki, Greece

MedicalResearch.com: What are the main findings of the study?

Dr. Iosifidis: A large outbreak of VRE colonization was found in neonates hospitalized in an intensive care unit (Neonatal Intensive Care Unit, NICU) after the implementation of an active surveillance program. Both high incidence of VRE colonization (or “colonization pressure”) and antibiotic use promoted VRE spread according to the results of the case control study. No proven sources of VRE were found (in local hospital or even in local livestock). A multifaceted management was implemented and included enhanced infection control measures, active surveillance cultures, cohorting of colonized patients, daily audits and optimization of antibiotic therapy. Although the outbreak had a biphasic pattern (monoclonal first wave followed by a polyclonal second wave) strict adherence to the aforementioned bundle of actions was proved essential for reducing VRE colonized cases. During the study period no new VRE infection occurred in neonates.

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